What antibiotic (ABT) is cephalosporin?

From the Guidelines

Cephalosporin is a type of antibiotic that includes ceftaroline, ceftobiprole, ceftazidime-avibactam, and ceftolozane-tazobactam, which are newer generation cephalosporins with broad-spectrum activity against gram-positive and gram-negative pathogens. These antibiotics have been studied in patients with community-acquired pneumonia (CAP) and have shown potential in treating resistant pathogens 1.

Key Characteristics of Cephalosporins

• Cephalosporins belong to the beta-lactam class of antibiotics and work by interfering with bacterial cell wall synthesis, ultimately causing bacterial cell death.
• They are effective against a wide range of gram-positive and gram-negative bacteria.
• There are five generations of cephalosporins, each with a broader spectrum of activity:
  1. First-generation: cefazolin, cephalexin
  2. Second-generation: cefuroxime, cefaclor
  3. Third-generation: ceftriaxone, cefotaxime
  4. Fourth-generation: cefepime
  5. Fifth-generation: ceftaroline

Clinical Use of Cephalosporins

• The choice of cephalosporin depends on the specific infection being treated, bacterial susceptibility, and patient factors.
• Dosing and duration vary based on the specific drug and indication.
• For example, ceftaroline has been shown to be superior to ceftriaxone in treating severe pneumonia in a meta-analysis of three randomized studies 1.

Safety and Efficacy

• Cephalosporins are generally well-tolerated, but patients with penicillin allergies may have cross-reactivity.
• Common side effects include gastrointestinal disturbances and rash.
• It's essential to complete the full course of antibiotics as prescribed to prevent antibiotic resistance. In the context of community-acquired pneumonia, ceftaroline is a recommended option due to its broad-spectrum activity and efficacy in treating severe pneumonia 1. However, the choice of cephalosporin should be guided by local resistance patterns, patient factors, and specific clinical scenarios.

From the FDA Drug Label

Cefuroxime, USP is a sterile semisynthetic, broad-spectrum, cephalosporin antibiotic for parenteral administration. Cefepime for injection, USP is a semi-synthetic, broad spectrum, cephalosporin antibiotic for parenteral administration. Ceftriaxone for Injection, USP is a sterile, semisynthetic, broad-spectrum cephalosporin antibiotic for intravenous or intramuscular administration.

The antibiotics that are cephalosporins are:

• Cefuroxime 2
• Cefepime 3
• Ceftriaxone 4

From the Research

Definition of Cephalosporin

• Cephalosporin is a class of antibiotics that are more resistant to inactivation by beta-lactamases compared to penicillins 5.
• They are classified into different generations based on their spectrum of activity against gram-negative bacteria 5, 6.

Classification of Cephalosporins

• First-generation cephalosporins have a narrow gram-negative spectrum but are most active against gram-positive bacteria, particularly Staphylococcus aureus 5, 7.
• Second-generation cephalosporins, such as cefoxitin, cefotetan, and cefmetazole, have the best activity against anaerobes 5.
• Third-generation cephalosporins have excellent activity against gram-negative bacteria, including Pseudomonas 6, 7.
• Fourth-generation cephalosporins, such as cefepime, provide excellent activity against gram-positive and gram-negative pathogens, including antibiotic-resistant Enterobacteriaceae 6.

Characteristics of Cephalosporins

• Cephalosporins are broad-spectrum antimicrobial agents with a favorable profile of toxicity compared to other antimicrobial agents 7, 8.
• They differ widely in their spectrum of activity, susceptibility to beta-lactamases, serum half-life, and penetration of the central nervous system 8.
• The use of cephalosporins is limited by increasing resistance among certain groups of bacteria and high cost, especially of the parenteral and recently licensed oral agents 9.